Chapter 1: Recovery
What is Recovery? · Recovery: a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential · Recovering planning is guided by the individual’s goals and dreams in the context of his or her personal gifts, strengths and skills while pursuing occupations in in his or lived experiences. · Participating in everyday activities that are needed and desired, individuals with mental illnesses and/or substance use disorders can achieve a state of health, wellness and recovery. · Client-centered '''practice: '''emphasis on a client’s autonomy and right to choose goals and/or interventions based on his or her identified needs for service · “Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve their full potential” · '''10 components of recovery 1. self-direction: optimizie autonomy 2. individualized and person-centered: there are multiple pathways to recovery 3. empowerment: control over one’s destiny, choose from a range of options 4. holistic: encompasses person’s whole life (mind, body, spirit, community) 5. non-linear: not step-by-step process, but a continual growth and learning process 6. strengths-based: focus on valuing and building on the multiple capacities, talents, coping abilities, and inherent worth of individual 7. peer support: mutual support-provide each other with a sense of belonging, supportive relationships, valued roles and community 8. '''respect: community, systems, and societal acceptance and appreciation of individuals 9. responsibility: have personal responsibility for their own self-care and journeys of recovery 10. hope: recovery provides the essential and motivating message of a better future · Procovery: attatining a productive and fulfilling life regardless of the level of health assumed attainable *Occupational therapists can facilitate recovery and procovery by teaching symptom management and coping strategies to structure one’s routine in a manner that supports well-being, promotes occupational role function, and facilitates engagement in occupations that are purposeful and meaningful to the person. · “Recovery is a product of dynamic interaction among characteristics of the individual (the self/whole person, hope/sense of meaning and purpose), characteristics of the environment (basic material resources, social relationships, meaningful activities, peer support, formal, services, formal service staff), and the characteristics of the exchange (hope, choice/empowerment, independence/interdependence)” o these factors impacting recovery can help and hinder the process Insights Into Recovery · '''Lived '''experience: the subjective perception of one’s experience of health or illness';' provides important insights into the nature of recovery o Recovery involves continual self-discovery, overcoming past issues and struggles with oneself and others, and building relationships that are supportive of the recovery process. · PhotoVoice: first person accounts of the lived experiences; images and stories that serve as examples of recovery-oriented narratives Recovery as a Process and Journey OTs can ask clients to reflect on their recovery stories as a means of tracking where they are on their journey, where they have come and where they hope to go. · Important aspects of client factor aspects of recovery include: o Importance of hope § '''Hope: expectation that something desired will occur. A sense that recovery is possible, and the possibility of a life with meaning and purpose, self-determination, and engagement in valued occupational roles that are important to the person can be attainable again o Coping and adaptation § Part of the recovery journey as a nonlinear, complicated process that includes setbacks that result in greater coping responses over time o Empowerment and self-determination § Elements of empowerment include: decision-making power, access to information and resources, variety of options from which to choose, assertive communication, hopeful future, constructive means of expressing anger, promoting change within oneself and the community, and image of self as improving and overcoming stigma § Self-determination: freedom with which an individual can choose important life and occupational issues such as where to live, what to do with one’s time, who to spend time with, and when, where and how to get help when experiencing a problem o Social and Community Integration § Social connections are important during recovery § Defined as, the opportunity to live in the community and valued for one’s uniqueness and abilities like everyone else. Includes housing, employment, education, health status, leisure, spirituality, citizenship, valued social roles, peer support and self-determination. '*'Hope is an essential concept in initiating one’s recovery, which is further fostered by a sense of empowerment, being connected with others, having access to resources, practicing self-determination, and having a clear sense of one’s values and life goals. Occupational Therapy and Recovery OT practice contributes to the complexity and meaning of the recovery vision o Encourage seeking and providing social support to develop reciprocal relationships important to a positive recovery. o Work participation acts as part of the process, and can occur at any point in recovery. OTs can promote engagement in work based on the client’s interest and goals within an environment that supports their confident engagement. o Emphasize habit formation as a supporter for a healthy recovery. 2 habits critical for a person in recovery to live more successful in their community: 1. Developing caring relationships 2. Being grounded in the present *Recovery is a personal journey of an individual with a serious mental illness or substance abuse use disorder in which OT can help the individual live beyond the diagnosis and symptoms, to achieve purpose, meaning and life satisfaction. Measurement of Recovery Assesses individual recovery (stage of recovery, service utilization, recovery markers) and factors in the service environment that are considered to reliance- and recovery- enhancing from the perspective of the service user’s ratings. · '''Recovery Self-Assessment o Based on nine principles: renewing hope and commitment, redefining self, incorporating illness, being involved in meaningful activities, overcoming stigma, assuming control, becoming empowered and exercising citizenship, managing symptoms and being supported by others · Making Decisions Empowerment Scale o Measures personal construct of empowerment; such as self-efficacy, self-esteem, power/powerlessness, anger, optimism and control over the future · Hope Scale o Self-report scale; useful for OTs interested in tracking improvement on sense of hope in clients they serve · Measurement of Community Integration o Measures participation and community integration that considers opportunities for involvement in community domains such as, housing, employment, education, health, leisure, spirituality, citizenship, social roles, peer support and self-determination. Recovery Principles Principles are consistent with the PEO (person-environment-occupation) model Assumptions regarding the recovery process: · Recovery occurs at an individual level and can be facilitated by families, friends, self-help groups and professionals · A range of activities can facilitate recovery · People who can be trusted to “be there” in times of need and who convey their belief in supporting the person’s recovery is essential to recovery · Diagnosis and medical interventions are not part of the recovery vision · Recovery can occur despite symptoms of the illness · Symptoms play a lesser role as person recovers · Recovery has growth and setbacks; but viewed as a gradual upward trend · Consequences of mental illness may be more challenging than the illness itself · Recovery for a person means that he or she has much to offer in recovery, not that he or she was not ill in the first place *Principles direct occupational therapists to pay attention to the recovery process and facilitate favorable outcomes associated with mental health recovery, and guide public policy and programs with a paradigm of recovery.